Provider Demographics
NPI:1629854591
Name:SPREDER, JESSICA (CPSS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SPREDER
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W 32ND ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-1107
Mailing Address - Country:US
Mailing Address - Phone:502-600-8306
Mailing Address - Fax:
Practice Address - Street 1:112 W 32ND ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41015-1107
Practice Address - Country:US
Practice Address - Phone:502-600-8306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist